RESUMO
Introduction: Premenstrual syndrome is defined as a set of physical and psychological symptoms that occur during the luteal phase of the menstrual cycle and gets better at beginning or during the first few days of menstruation. Among these complaints, depression and anxiety are more common and aversive
Objective: The present study aimed to compare the effectiveness of group cognitive behavioral therapy and group cognitive hypnotism for anxiety and depression in women with premenstrual syndrome
Methods: This quasi-experimental study was conducted on 300 women referring to health centers affiliated to one of the health centers in Rasht in 2013. According to Morgan sampling table [after Spiegel test, to evaluate the possibility of hypnosis and completing the premenstrual syndrome questionnaire during two consecutive cycles]. 30 patients with the highest score of anxiety and depression were selected using purposeful sampling. Sample size was determined considering the fact that group psychological therapies usually include 8-12 individuals. After obtaining consent from the participants, they were divided into three groups randomly [two experimental and one control]. The first experimental group received eight sessions of cognitive behavioral group therapy aimed at reducing depression and anxiety during menstrual cycle. Similarly, the second group received eight sessions of group cognitive hypnosis therapy to reduce anxiety and depression in their monthly period. The third group served as a control group. Inclusion criteria were reproductive age, upper than high school education and no mental illness. Exclusion criteria were positive Spiegel test [unable to move pupils] to perform the hypnosis. Spiegel is a common test to evaluate the possibility of being hypnotized. It has three degrees and the pupils' movements are used for estimation. The ones who have a poor ability to raise their pupils have a little possibility for hypnotism while the third degree shows the ability to raise pupils which manifest Sclera. The following instruments and tests were used to measure the study variables: 1. Premenstrual questionnaire: evaluates the severity of symptoms related to premenstrual syndrome which was completed during two consecutive cycles by patients who had referred to health centers. The minimum and maximum scores of this tool was designed zero to 66. 2. Beck Depression Inventory [BDI]: Beck's questionnaire on Symptoms of Depression. 3. Beck Anxiety Inventory [BAI]: is a self-report questionnaire to measure the severity of anxiety symptoms. The minimum and maximum anxiety and depression scores were between zero and 63, respectively. Mean of all of the three tools were used for judgment. After scoring all questionnaires by the three groups in pretest and posttest, the data were analyzed using descriptive and inferential statistics including t-test, ANCOVA, ANOVA and Tukey test
Results: Most of the subjects were more than 20 years old, married and high school graduate. The results showed that both cognitive behavioral therapy and hypnosis were effective on reducing anxiety and depression symptoms in premenstrual syndrome [p<0.05]. Moreover, no significant difference was observed between cognitive behavioral therapy and hypnosis in reducing anxiety and depression. Comparison of means showed a significant difference in reducing symptoms of depression between cognitive behavioral therapy and control group [P=0.005]. Interestingly, after treatment a significant was seen in level of anxiety between the groups [P=0.001]. Hypnosis group compared with the control group, showed a significant difference in the symptoms of depression [P=0.018] and anxiety [P=0.005]. Finally, the results suggested that both cognitive behavioral treatments and cognitive hypnosis significantly reduced depression and anxiety in the intervention groups. However, no significant difference was found between these two treatments in reducing depression and anxiety. In other words, both cognitive behavioral therapy and cognitive hypnosis were effective on reducing anxiety and depression to the same extent
Conclusion: Study results showed effectiveness of psychological therapies on treatment of premenstrual syndrome. Due to less complication, these therapies are more recommended than medical treatments. Considering the similar effectiveness of cognitive behavioral group therapy and hypnotism therapy, hypnotherapy is suggested especially in women's diseases
RESUMO
The relation between stress and gastrointestinal diseases, particularly irritable bowel syndrome [IBS], has received consideration for years. This research was conducted to compare the attachment styles and coping strategies in IBS and healthy female students. This case - control study was conducted on 50 female students with irritable bowel syndrome and 50 healthy students in Gorgan, Iran during 2011. Age, grade and major were similar in both cases and controls. ROME III criteria questionnaire, together with a physician report confirmation were used to diagnose IBS. All attendants in the study filled in Rass adult attachment scale questionnaire and Lazarus coping strategies questionnaire. Data were analyzed using SPSS-17 and student t-test. In the IBS group the level of ambivalent [9.78 +/- 2.72] and avoidance [7.68 +/- 1.76] attachments were higher than the control group [8.1 +/- 2.65 and 6.56 +/- 1.82 respectively] [P<0.05]. The most prevalent attachment style in control group was the secure style [11 +/- 3.89]. There was a significant statistical difference between female of IBS group and control group regarding the mean +/- SD of coping strategies including: isolation [7.04 +/- 2.44, 5.9 +/- 1.95], self-control [9.62 +/- 2.39, 8.32 +/- 1.6], demanding social support [5.54 +/- 1.6, 6.92 +/- 2.42], evasion - avoidance [9.64 +/- 2.81, 6.8 +/- 1.37], solving the problem [8.2 +/- 1.85, 6.66 +/- 1.7], re-evaluation [16.2 +/- 1.81, 14.3 +/- 1.61] and taking responsibility [5.67 +/- 1.41, 4.5 +/- 1.58] [P<0.05]. The direct coping strategy in IBS and control groups was 63.76 +/- 9.76 and 67.58 +/- 10.78. This difference was not significant. This study showed that in comparison to healthy female students, subjects with IBS use more ambivalent and avoidant attachment styles